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前列腺癌的遗传学。

Genetics of Prostate Carcinoma.

机构信息

Ljudevit Jurak Department of Pathology and Cytology, Sestre Milosrdnice University Hospital Centre, Zagreb, Croatia; Department of Pathology, School of Medicine, University of Zagreb, Zagreb, Croatia.

University of Zagreb, School of Medicine, Scientific Group for Research on Epigenetic Biomarkers, Zagreb, Croatia.

出版信息

Acta Med Acad. 2021 Apr;50(1):71-87. doi: 10.5644/ama2006-124.327.

Abstract

The aim of this review is to provide a brief overview of some current approaches regarding diagnostics, pathologic features, treatment, and genetics of prostate carcinoma (PCa). Prostate carcinoma is the most common visceral tumor and the second most common cancer-related cause of death in males. Clinical outcomes for patients with localized prostate cancer are excellent, but despite advances in prostate cancer treatments, castrate-resistant prostate cancer and metastatic prostate cancer patients have a poor prognosis. Advanced large-scale genomic studies revealed a large number of genetic alterations in prostate cancer. The meaning of these alterations needs to be validated in the specific prostate cancer molecular subtype context. Along these lines, there is a critical need for establishing genetically engineered mouse models, which would include speckle type BTB/POZ protein and isocitrate Dehydrogenase (NADP (+)) 1 mutant, as well as androgen receptor neuroendocrine subtypes of prostate cancer. Another urgent need is developing highly metastatic prostate cancer models, as only up to 17% of available models display bone metastases and exhibit a less typical neuroendocrine prostate cancer or sarcomatoid carcinoma. Moreover, androgen deprivation and relapse should be mimicked in the genetically engineered mouse models, as androgen independence may yield a better model for metastatic castrate-resistant prostate cancer. The development of such refined animal models should be guided by comparative genomics of primary versus corresponding metastatic tumors. Such an approach will have the potential to illuminate the key genetic events associated with specific molecular prostate cancer subsets and indicate directions for effective therapy. CONCLUSION: Despite excellent results in the treatment of localized prostatic carcinoma, castrate-resistant prostate cancer and metastatic prostate cancer have a poor prognosis. Advanced large-scale genomic studies revealed a large number of genetic alterations in PCa. Experimental models of prostate carcinoma in genetically modified mice could provide new data about the genetic changes in such cancers and help in developing better animal models for treatment resistant prostate carcinomas.

摘要

本文旨在简要概述前列腺癌(PCa)在诊断、病理特征、治疗和遗传学方面的一些当前方法。前列腺癌是最常见的内脏肿瘤,也是男性癌症相关死亡的第二大主要原因。局限性前列腺癌患者的临床结局良好,但尽管前列腺癌治疗取得了进展,去势抵抗性前列腺癌和转移性前列腺癌患者的预后仍较差。先进的大规模基因组研究揭示了前列腺癌中大量的遗传改变。这些改变的意义需要在特定的前列腺癌分子亚型背景下进行验证。在此基础上,迫切需要建立遗传工程小鼠模型,包括斑点型 BTB/POZ 蛋白和异柠檬酸脱氢酶(NADP(+))1 突变体,以及雄激素受体神经内分泌前列腺癌亚型。另一个迫切需要解决的问题是开发具有高转移性的前列腺癌模型,因为只有多达 17%的现有模型显示骨转移,并且表现出不典型的神经内分泌前列腺癌或肉瘤样癌。此外,遗传工程小鼠模型中应模拟去势和复发,因为雄激素非依赖性可能为转移性去势抵抗性前列腺癌提供更好的模型。这种改良动物模型的开发应受到原发性和相应转移性肿瘤的比较基因组学的指导。这种方法有可能阐明与特定分子前列腺癌亚群相关的关键遗传事件,并为有效的治疗指明方向。结论:尽管局限性前列腺癌的治疗效果良好,但去势抵抗性前列腺癌和转移性前列腺癌的预后仍较差。先进的大规模基因组研究揭示了前列腺癌中大量的遗传改变。遗传修饰小鼠的前列腺癌实验模型可以提供有关此类癌症遗传变化的新数据,并有助于开发治疗抵抗性前列腺癌的更好动物模型。

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